Feb 252019

Gastroenterology is the study of the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. Medicos Library has provided high standard Gastroenterology Notes by Dr. Yousif Abdallah Hamad.

Summary of Notes:

Blood supply Bleeding from Posterior duodenal ulcers are due to erosion of the gastroduodenal artery 

  • The right and left gastroepiploic arteries (gastro-omental arteries) supply the greater curvature of the stomach.
  • The source of ulcer bleeding in the greater curvature of the stomach
  • Left gastroepiploic artery
  • The right gastric artery arises from the hepatic artery or the left hepatic artery, supplies the pylorus and travels along the lesser curvature of the stomach, supplying it, and anastomosing with the left gastric artery.
  • The cause of ulcer bleeding in the lesser curvature of the stomach
  • right gastric artery
  • The pancreaticoduodenal artery (a branch of the gastroduodenal artery) supplies mainly the upper and lower duodenum and the head of the pancreas.
  • The right hepatic artery supplies the right lobe of the liver and part of the caudate lobe.

Acid secretion
Principle mediators of acid secretion
 gastrin
 vagal stimulation
 histamine
Factors increasing acid secretion
 gastrinoma
 small bowel resection (removal of inhibition)
 systemic mastocytosis (elevated histamine levels)
 basophilia
Factors decreasing acid secretion
 drugs: H2-antagonists, PPIs
 hormones: secretin, VIP, GIP, CCK  Prostaglandins.

Intrinsic factor

  • Intrinsic factor is a glucoprotein secreted from the parietal cells of the stomach in response to gastrin, food or histamine.
  • intrinsic factor transport vitamin B12 across the mucosal wall.
  • When the vitamin B12 bound to intrinsic factor reaches the terminal ileum, it binds to receptors on the surface of the mucosal cells and is able to cross the membrane and enter the cytoplasm.
  • The intrinsic factor is then replaced by transcobalamin II which transports the B12 out of the cell and into the bloodstream.

Advice form Dr. Yousif Abdallah Hamad

How to use the notes to study for MRCP:

  • Initially, you need to skim through the notes at least twice to build up an idea about the syllabus of MRCP. Highlight any portion that is difficult so that you can concentrate on that during your revision.
  • Next proceed to the question banks. You can choose to do Passmedicine, onexamination or Pastest. I usually recommend students to do Passmedicine and the Pastest.
  • As you go through the questions make a super-revised notes of your own. Write down in one sentence what you learned from the question you just attempted.
  • If you get any question wrong or you get confused then return to the notes and re-read one more time before attempting the question again. And write down the point in red in you revision notes so that you can skim through it easily during your revision.
  • I have highlighted some points in yellow and green to help you concentrate on those points. As you go through passmedicine and pastest, you can highlight the points further to help in your revision.
  • During your revision before the main exam, only read the highlighted portions including those that you highlighted when practicing the question bank. And also read your super-revised notes that you made from the question banks.

I believe these method has worked for many students and will help you in your journey to be successful in MRCP part 1 and as well as build your basics for Part 2.

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Find more Notes By Dr. Yousif Abdallah Hamad

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